Fur Coats Can Prevent Flu – The 1918/19 Pandemic

A century ago England, along with most of the world, was gripped by the flu pandemic. As far as I’m aware none of my immediate ancestors, or their families, died as a result of it. But the mortality rate was the tip of the iceberg as whole communities struggled to cope with the infection and its effects.

In this blog post I will give a national overview, before looking at its effects locally on Batley to try give a feel for the impact on the day to day lives of my ancestors. The sources I will use can be adapted to look at the effect of the pandemic on other localities in England.

In 1920 the government published a Supplement to the Registrar-General’s 81st Annual Report on Births, Deaths and Marriages in England and Wales. It covered mortality from influenza during the 1918/19 epidemic in these two countries. Its severity is starkly conveyed in the myriad of statistics contained within the report. It stated in 1918 influenza accounted for 112,329 deaths split between 53,883 males and 58,446 females. 7,591 of the male deaths were non-civilians. So, in total, 104,738 influenza deaths were amongst the civilian population. This corresponded to a death rate of 3,129 per million civilian population. The report continued:

No such mortality as this has ever before been recorded for any epidemic in this country since registration commenced, except in the case of the cholera epidemic of 1849, when the mortality from that cause rose to 3,033 per million population.

It was recognised this was not representative of total mortality as a result of influenza, as other causes of death could also have an underlying influenza link. These causes included other respiratory diseases, chiefly pneumonia and bronchitis. Phthisis and heart disease were also cited as other possibilities where influenza may have impacted. Attempts to quantify influenza-linked mortality from these were made, but the results varied depending on methodology and were acknowledged to be unsatisfactory. One estimate put it at around 200,000 deaths from influenza and influenza-linked illnesses. As many as a quarter of the population caught the disease.

One other factor which skewed results when looking at the influenza statistics was the depletion of the male population due to war service. One way to deal with it was to look at the female population in isolation. This methodology was notably used to examine the age distribution of mortality due influenza and comparing it to the age distribution normally expected of influenza. It was here the difference between the 1918/19 flu strain and previous epidemics was most notable.

Deaths at [ages] 0-15 and especially at [ages] 15-35, which had formed since 1889 a fairly uniform proportion of the whole number, with a tendency of late years to decrease in relative importance, suddenly increased from 7-11 per cent. at [ages] 0-15 to 25 per cent., and from 8-10 per cent. at [ages] 15-35 to 45 per cent. In middle age, [ages] 35-55, the proportion was comparatively little affected, but shows some increase over the years immediately preceding. At [ages] 55-75 and at ages over 75, which together had for many years provided 60-70 per cent. of the total deaths registered, the proportion fell to 10 per cent. at [ages] 55-75, and 2 per cent. at 75 and upwards.

The report then went on to look at the course and local distribution of the epidemic in England and Wales. Three definite waves were identified:

The weekly death rate was examined in various localities, including regions, county boroughs, and other towns with populations greater than 20,000. This was extrapolated to give a corresponding annual death rate per 1,000 of the living population using the 1911 census as a population baseline. Batley fell into the category of towns with a population over 20,000. The peak mortality weeks for Batley in each wave were:

Other statistics included ranking areas according to numbers of deaths. There were 161 towns who were not county boroughs falling into the over 20,000 population category. Batley over the complete period of the epidemic was ranked the 18th most affected. In terms of the individual waves it was 27th in Wave 1, 71st in Wave 2 and 8th in Wave 3.

Looking at county boroughs close to Batley, Dewsbury ranked the 11th most affected of the 82 county boroughs (in terms of the individual waves it was 15th in the first, 17th in the second and 15th in the third). Huddersfield was 65th, (2nd, 82nd and 21st in the respective waves).

The West Riding of Yorkshire was over the course of the epidemic the 5th worse affected of the 61 counties (position in the respective waves 4th, 11th and 8th).

Local level reports were also compiled. In Batley the Medical Officer, G.H. Pearce, submitted a full report to the Town Council in January 1919 about the incidence of the disease locally and the steps taken to combat it. His 1919 Annual Report also covered the epidemic locally.

These Annual Reports by the Medical Officer give a useful overview of the town. The 1919 report includes the following description:

PHYSICAL FEATURES AND GENERAL CHARACTER OF THR DISTRICT. – Batley is a municipal borough constituted by Royal Charter, December 8th, 1868, consisting of four wards and governed by a Mayor, seven Aldermen and twenty Councillors. The borough has a separate Commission of the Peace. Geologically Batley is situated mostly upon clay, under which is sandstone through which is various beds of coal. The situation is hilly, the highest point being 475 feet above sea level and the lowest 150. Batley is entirely an industrial town the chief occupation of the inhabitants being the manufacture of heavy woollen goods, shoddy and mungo. The Rag trade also employs a large proportion of the inhabitants. The majority of the population not working in the numerous mills earn their living in the coal mines, at ironworks, on the railway, as teamers, general labourers, etc. More females than males are employed in the textile mills…..As rags from all parts of the world are brought into the town it would be reasonable to expect that risk of infection would be likely to arise therefrom, but practical experience does not prove such to be the case. Apart from the dust in connection with this and similar trades, also the risk of contracting anthrax, run by workers in wool, there appears to be no particular occupation in Batley exercising an exceptionally adverse influence on the public health.

Batley’s population growth from 1851 is illustrated in Table 1 below. The 1911 population of 36,395 compared to the 3,227 acres for the town gives a population per square mile of 7,218. Mortality in any district is adversely affected when there are more than 400 people to each square mile.

Table 1

The Registrar-General also made an estimate of Batley’s 1919 population, which was included in the Medical Officer’s report. Based on the birth rate he put it at 36,593 and death rate resulted in a figure of 35,128. An analysis of mortality and the annual death rate per 1,000 of civilian population for 1919 gave a figure of 16.1 for Batley, higher than the national England and Wales figure of 13.8.

Table 2 shows the causes of death in Batley between 1912 and 1919 attributed to influenza, as identified in Batley’s Medical Officer’s report. I have also included those causes which may have influenza as an underlying issue, as identified in the Registrar-General’s Supplementary Report.

Table 2

Influenza was the direct cause of 104 deaths in Batley during 1918, with a further 83 deaths in 1919 attributed to it. In 1920, according to the following year’s Batley Medical Officer’s report, influenza was certified as the cause of 7 deaths.

So how did all this impact on everyday life in Batley? I decided to focus on the newspapers for the period. From July onwards the Batley News began to carry local reports, including Council updates. Batley Borough Council minutes are therefore an alternative source of information. Bound yearbook copies are at Batley Library (as are the Medical Officer reports), with original Batley Borough documentation held at West Yorkshire Archives (Kirklees Office) in collection Reference KMT1.

One huge factor in reporting the epidemic was censorship. When flu struck Britain, the Great War was still far from won and censorship was in full force. Reporting of anything which may impact on morale and signify any form of weakness to the enemy or difficulties in pursuing the conflict was banned. Reporting restrictions similarly applied in other combatant nations. This was why the pandemic was incorrectly attributed to Spain. As a neutral country the same press restrictions did not apply and news of the epidemic there was freely reported from May 1918. It meant that this country was wrongly assumed to be the origin of the illness – not the likely source country, the United States. The first reference to the ‘Spanish disease’ was in the British Medical Journal (BMJ) in August 1918, and ‘Spanish Flu’ was what it became commonly known as. The same reporting restrictions therefore mean that newspaper reports may have underplayed the full impact of the illness.

First mentions of influenza locally noticeably began to appear in early July 1918 with the 6 July edition of the Batley News reporting a Council exchange that it was hoped the schools would remain open as although a number of teachers were ‘down’ with influenza there had been no serious report from any one school.

The 13 July edition of the newspaper, when reporting the death of Harry Boyes, Royal Field Artillery, at Staincliffe Hospital indicated that Colonel Russell believed the pneumonia which has stricken him after his initial injury had been caused by influenza “of which the Hospital is full.”

This edition of the newspaper coincided with the peak week for the first wave of the flu epidemic in Batley. The newspaper reflected this. Despite the optimism of the previous week, Batley schools were closed on 10 and 11 July; with 1,900 absences on reopening on the 12 July they were once more shut on the 13 July. The paper published the advice of Dr. Pearce, Batley’s Medical Officer as follows:

Influenza is caused by a minute bacillus found in the sputum and nasal discharge of persons suffering from the disease. It is conveyed by the breath. The disease is highly contagious. One attack does not confer immunity from another. The onset, after exposure to infection, may be as short as a few hours, and is characterised by a sudden rise of temperature, severe headache, pains in the back of the eyes, muscular aching and pains in muscles of both arms, legs, back, and other parts of the body, rapid pulse, much thirst, furred tongue, redness of inside of throat, which may or may not be sore. The skin is generally dry, but sometimes there is perspiration. The temperature generally falls in 24, 36, or even 48 hours as rapidly as it rose. The pains in the limbs continue longer, together with a sense of prostration for several days. There may be a relapse.

Influenza is rarely fatal, excepting through one of its inflammatory complications such as pneumonia.

The Medical Officer went on to advise that those stricken should at once have a hot bath, go straight to bed and send for the doctor. They should be isolated to prevent, as far as possible, the spread of the disease. The best way to escape infection was to avoid badly ventilated places such as picture palaces and theatres, and public meetings. Those displaying symptoms of bad colds should similarly be avoided.

Regular life, with the avoidance of all excess, plenty of fresh air and sunlight, with free ventilation of rooms, together with open air exercise and a proper number of hours in bed, is advised.

Despite the Medical Officer’s assertion that the disease was rarely fatal, the number of deaths reported in that week’s newspaper must have given readers pause for thought. These deaths included what was believed to be the first one locally from “the mysterious influenza epidemic,” that of 34-year-old Sarah Elizabeth Driver, wife of Sam Wiloughby Driver, a warehouseman, of 12 Calder Bank Road, Dewsbury. She died on Sunday 8 July 1918, after being taken ill suddenly the day before. By Sunday, when spitting what appeared to be blood, her husband went to see Dr. Pritchard who refused to visit the patient on a Sunday, saying he had hundreds of cases of this complaint [influenza] lately, and not one had caused him anxiety or worry. Despite Mr Driver saying he would not have come had he thought it not serious, Dr. Pritchard sent him away with some medicine. By 6pm that evening Sam Driver returned to Dr. Pritchard’s, but the doctor was out. Before he was able to call another doctor, Sarah Elizabeth died. Dr. R. Beattie, who undertook the post mortem, thought Mrs Driver may have recovered if she had received prompt medical aid. But he also added doctors were so busy at the moment with the influenza outbreak they did not “know which way to turn.” The inquest verdict was she “Died from acute influenza and heart failure.”

By 20 July 1918 the town was still dealing with the effects of influenza, with interments in Batley cemetery for the week numbering around 20, double the normal average. However the illness itself was on the decline with far fewer local death reports featuring in that week’s edition of the paper, which quoted:

…..a prominent local practitioner yesterday stated that so far as his experience goes the disease is rapidly declining. Where he used to have a score of patients he has now about two.

The 27 July 1918 paper declared the influenza epidemic practically over, although the occasional death report continued to appear, including that of Mr George Richard Whiteley or Purlwell, age 30, described as a champion Batley swimmer. His death on 29 July, from double pneumonia and pleurisy following influenza, was reported in the 3 August edition of the paper.

The respite was short-lived. By the end of October 1918 flu was once more hitting the local headlines. The 26 October 1918 edition of the Batley News, whilst admitting not too many local victims as yet, was not complacent:

Influenza, which in some parts of the country is raging in virulent epidemic form, has not many victims in this locality. In view, however, of the remarkable rapidity with which whole districts are affected, and of the large percentage of deaths reported from pneumonia following influenza, it is wise that everybody should take simple precautions against contracting the disease and to avoid communicating it to others. These precautions are precisely the same as against catching cold, and the most important are warm clothing and plenty of fresh air. “Weak persons and those suffering from colds should,” says one of the Medical Officers of the Local Government Board, “avoid badly ventilated buildings and overcrowded assemblies. A person who has contracted a severe cold should keep away from work, if he is employed with others, for the first three or four days, as it is during this stage that the complaint is most infectious. If people did that and were less neglectful of personal hygiene and more careful not to cough or sneeze without covering the mouth, there would be far fewer colds and far less spread of influenza.”

The warning about how quickly the illness could assume epidemic proportions was proved correct. By 2 November 1918 it had returned once more to the town with the Batley News reporting four deaths, many school children affected and the Medical Officer deeming it necessary to close all but four schools. Those shut included Purlwell, St Mary’s R.C., Carlinghow (all deparments); Gregory Street (both departments); Mill Lane Mixed, Warwick Road Girls’ and Infants’, Park Road Girls’ and Infants, Hanging Heaton C.E. Mixed and Infants’ and Field Lane Infants’.

At the same time notices were issued to all places of amusement in Batley that, until the 11 November, the period during which the majority of schools were to be closed, no children under fourteen must be allowed to attend. Parents were warned about “gossiping from house to house” and told not to let their children go to households were members were stricken by the illness. With the 11 November Armistice, it was particularly difficult to heed this advice about public gatherings and gossiping with neighbours. The crowds celebrating the Armistice clearly exacerbated the spread of the disease by bringing large groups of people into close proximity.

And whilst mentioning the Armistice it is worth noting the effects of influenza on the local men serving in the military. I know from my St Mary of the Angels, Batley, War Memorial research five of the 76 men (6.5 per cent) died as a result of influenza-related illnesses. Tony Dunlop of Project Bugle, the Batley and Birstall First World War Commemoration Project, estimates around 75 per cent of those who died and were buried locally in the last three months of 1918 were flu or pneumonia related deaths; of the others overseas, flu and pneumonia accounted for possibly around 30 per cent. These epidemic victims included Gunner Edward Chadwick, Sergeant Fred Greenwood and Deck Hand Harold Gaunt.

But back to the education situation. The school closures continued, despite attempts to re-open. On the days when schools did open, attendances proved thin because some children were themselves stricken with the illness, or their parents kept well children at home for fear of contagion. At the end of November Batley’s Medical Officer once more decreed schools would remain shut until 9 December.

At the end of November 1918 the Local Government Board, the national body which oversaw Local Authorities who at this time were largely responsible for health care, issued a special regulation. It meant if any public elementary school was temporarily shut because of influenza, no children were to be allowed to visit cinemas or places of public entertainment. Another regulation stipulated that no public entertainment was to be carried on for more than four hours consecutively, and an interval of not less than thirty minutes between entertainments must be observed during which time the venue was to be effectively ventilated. The penalty for any breach was £100.

But, seemingly at odds with the general discouragement of public gatherings, the 30 November Batley News announced that Batley’s Medical Officer had arranged for the showing in local picture halls of “Dr. Wise on Influenza” telling people what to do, or avoid, in the current epidemic! The film, commissioned by the Local Government Board and described as hard-hitting, can be viewed here.

Bored children not occupied by school did find other ways to amuse themselves, some not entirely legal. In February 1919 three boys appeared in court for stealing indiarubber piping from heating apparatus at St John’s Sunday School, as well as six cart lamps. Described as being from respectable families, a mother of one of the boys voiced the opinion that the lads got into mischief whilst the schools were closed for influenza. Courts were affected in other ways too with cases adjourned due to illness . For example in March 1919 a case about alleged breaches of the Rationing Order was halted as two of the defendants, Robert Spedding senior (butcher, of Clark Green) and Grace Reid (milk dealer of Purlwell), were unable to attend Batley Police Court

School closures also had a financial impact. Around 890 schools governed by the West Riding County Council (so not Batley Borough) were closed on average three times during 1918 as a result of the influenza epidemic, involving a loss of grants of around £16,000. The Council also paid over £100,000 to teachers when they were not teaching because of school closures.

It also impacted on those wishing to leave school to take up employment – in March 1919 it was reported that 147 children in Batley failed to attend school the requisite number of days to obtain Labour Certificates. Some Councillors felt that these children were entitled to special consideration given the circumstances. However, the Board of Education forbade them to take into consideration any possible attendances the children may have made if the schools had not been closed on account of the influenza epidemic. This was particularly vexing for some because at this point in time when a child reached the age of 13 and had made 350 attendances for each of five years they could apply for a Labour Certificate, allowing them total or partial exemption from school in order to work. The 1918 Education Act changed the law – from 1 April 1919 all children remained in school until the next holiday after their 14th birthday and Labour Certificates for leaving school before this age were abolished.

The week ending 23 November 1918 saw the peak of the second wave in Batley. By now the illness was impacting on medical services, and the end of the war provided a possible solution. In view of its prevalence in Batley at the end of November, the local Council made an application for the return of two local doctors serving in the Forces. However, the problems with doctors unable to meet the demands placed on them was still evident well into February 1919, as indicated in another inquest where two doctors failed to attend the victim, Mrs. Ann Elizabeth Senior (46) of Earlsheaton. Again this was in the neighbouring town of Dewsbury, and it was Dr. Beattie who once more conducted the post-mortem, saying if she had been seen her life may have been saved.

Proposals to treat influenza patients in isolation hospitals such as the one at Oakwell proved tricky due to the difficult staffing situation – by the end of January the hospital only had six nurses to keep five wards operational, and obtaining extra staff was proving impossible. The pressure on Oakwell to change policy increased though when, from 1 March 1919, the Local Government Board made primary pneumonia and pneumonia following influenza notifiable diseases. The aim was now to treat such cases in isolation hospitals if arrangements could be made, as this would save lives. Finally Oakwell was made available for pneumonia cases at the end of March 1919 for those patients where suitable nursing and accommodation was not available at home. These suitable cases were decided by the Medical Officer.

Remedies for influenza proliferated and included gargling morning and night with a solution of potassium permanganate and salt in water. It was also recommended that the solution be inhaled. Adverts appeared in the papers too, including for Crosby’s Cough Elixir, Lifebuoy Soap and, in March 1919, the claim from Ward’s (a clothing store) that you could protect yourself against flu by wearing a fur coat! This presumably based on the wear warm clothing advice.

Because of the heavy death toll throughout November 1918, (54 due to influenza and 13 to pneumonia) gravediggers were in short supply. In the five weeks to 30 November there were 95 funerals at Batley Cemetery, compared to 39 in the same period in 1917. The Registrar and cemetery staff came under particular pressure, resulting in distressing delays to burials. As a consequence the Council secured the services of four privates from a Labour Battalion to work in Batley Cemetery to try alleviate the problems.

By the end of December the second wave was over. The Medical Officer reported of the 62 Batley deaths that month, 16 were from influenza, seven were from bronchitis and four due to pneumonia. But once more it was only a temporary lull.

By the end of February the influenza scourge was back again in Batley – the third wave of the disease. That month Dr. Pearce, the Medical Officer for Batley, reported 26 deaths from influenza, 20 from bronchitis and 8 from pneumonia. The Batley News of 1 March 1919 reported its comeback, but stated it was of a milder type with elementary school closures unnecessary and only six deaths attributed to it the previous week.

That same edition shone a spotlight on Batley’s housing conditions. Dr. J H Wood, J.P., whilst giving a talk to the Batley District Nursing Service ‘musical’ afternoon, touched on the three severe influenza epidemics over the previous eight months. Describing the disease as a plague, he claimed that although fresh air and face masks were all well and good, the problem was people attempting to fight the disease instead of going to bed and making the best of things. He then turned to the acute housing problem in Batley. He knew of one house consisting of one room downstairs and two bedrooms occupied by 12 people, one of whom was a chronic invalid. This was not an isolated case. Some of the housing conditions were a menace to public health, yet the health authorities were helpless to resolve them.

It was certainly true that overcrowding posed a public health problem. Influenza affected multiple family members during the epidemic, and true isolation from the rest of the household proved impossible when space was so limited. The newspapers are full of examples of multiple stricken family members – the same edition as reported overcrowding also mentioned five members of a Mount Top family in Birstall affected by influenza. Other examples included Mrs Senior, referred to earlier, who was one of six in her household to be laid low by the flu. The inquest into the death of Lewis Gomersall (47), a coal miner from Hanging Heaton who died on 21 February 1919, heard that four or five other members of his family were afflicted. One report which struck me was in the 30 November 1918 Batley News as follows:

Healey

Two Deaths in One Family from Influenza

Deep sympathy will be felt for Mr. John Edward Barber, rag merchant, 6, Mortimer Avenue, Healey, whose wife and daughter [Cecilia (60) died on 24 November and Nellie (26) died on 28 November]…..have this week died from influenza. Five members of the family have been attacked by the complaint, and Alice, another daughter, has been at death’s door and has not yet heard of the loss of her mother and sister. A double funeral takes place at Batley Cemetery tomorrow.

It is the street on which I grew up.

However, arguably the most ‘famous’ family in the town to be affected by the flu, and one that did not come into the class of overcrowded households, was that of Mr Theodore Cooke Taylor, J.P., of Sunny Bank, Batley. He was the head of the woollen manufacturing and profit-sharing firm of Messrs. J. T. and J. Taylor Ltd. He too suffered a double blow, but at a time when the epidemic was finally waning. He contracted flu along with his wife and daughter in early April 1919. Whilst he recovered, his daughter, Evelyn Sara Taylor (43), died on 27 April 1919 from bronchial pneumonia complications; his wife Sara Jane (67) died two days later on 29 April 1919. Their burial took place in Batley Cemetery on 1 May 1919.

By the end of May 1919 Batley and District Insurance Committee were able to declare that the pneumonia plague, arising from influenza, was finally subsiding. But it was at a cost of almost 200 lives directly attributed to influenza, not to mention those who succumbed to the subsequent respiratory complications.

Sources:

Supplement to the Eighty-First Annual Report of the Registrar-General of Births, Deaths and Marriages in England and Wales, Report on the Mortality from Influenza in England and Wales During the Epidemic of 1918-1919